Antipsychotic Use in US LTC Facilities Connected With Staffing Levels

With prior evidence suggesting staffing levels in long-term care (LTC) facilities may impact rates of inappropriate antipsychotic use, researchers examined the connection between antipsychotic prescribing and staffing in LTC facilities.

Data on US LTC facilities between 2016 and 2018 was extracted from the Nursing Home Compare and LTCFocus datasets, which also contained information from the Minimum Data Set database on facility characteristics and staffing measures from the Payroll-Based Journal system.

Of the 10,436 facilities included, the mean staff level was 3.69 (SD = 0.67) staffing hours per patient per day. The mean antipsychotic use rate across all facilities was 15.24% (SD = 8.62%).

Researchers reported a 0.75% decrease in inappropriate antipsychotic prescribing per unit increase in overall staff-to-patient ratio. There was a 3.09% decrease in inappropriate antipsychotic prescribing per unit increase in licensed staff hours.

“More specifically, we saw a 2.25% decrease per unit increase in RN staffing hours, a 1.83% decrease per unit increase in LPN staffing hours, and nursing aide staffing hours were not associated with antipsychotic use,” wrote study authors.

“These findings provide support for policy-based interventions to decrease antipsychotic use in LTC facilities by improving staffing skill mix and staffing levels,” wrote researchers.

Researchers concluded that nursing staff education and training on antipsychotic prescribing practices may also be informed by these results.

Reference:
Chappel V, Kirkham J, Seitz DP. Association between long-term care facility staffing levels and antipsychotic use in US long-term care facilities. J Am Med Dir Assoc. Published online August 1, 2022. doi:10.1016/j.jamda.2022.06.029